Ophthalmologists and optometrists are medical practitioners who manage diseases, disorders, and other conditions of the eye. Starting from generic consultations to complex eye surgeries, there are so many services offered by ophthalmologists and optometrists on an everyday basis.
Ophthalmology billing and coding involves being precise and thoughtful while creating claims and writing codes. Multiple combined services could be offered to a patient who visits an ophthalmology practice, and all these services need to be captured right for claims to be inclusive.
Documentation is something that billers find challenging in a busy practice. When multiple clients walk in or make appointments on a single day, processes like pre-authorization checks and eligibility verifications become challenging. When these are not done right, the practice suffers when reimbursements are requested.
Coding is one of the most challenging parts of medical billing. There are multiple groups of codes available for different services offered, including the following.
Generic procedures
New patient services and procedures
Existing patient services and procedures
Ophthalmoscopy procedures
Specialized services and procedures
Contact lens services
Intravenous procedures
Even after a claim is prepared, the process is only half done. Your billers need to be adept in sending the claims to the payer on time, understand rejections/denials reasons, decide whether or not to re-appeal, and be in great working relationships with payers to keep the process flow going.
A third-party RCM service provider can add so much value to your backend processes without disrupting the existing processes. A brand like Quintessence can improve your revenues and bring down business costs with a few smart changes to the revenue cycle and by deploying smart tools.
The below are sub-specialties of ophthalmology, and Quintessence is equipped to handle RCM services for all of these.
Pediatric ophthalmology
Glaucoma
Neuro-ophthalmology
Ocular oncology
Plastic and reconstructive surgery
